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A model to predict motor performance in preterm infants at 5 years
Anjo J W M Janssen1, Maria W G Nijhuis-van der Sanden, Reinier P Akkermans
1Radboud University Nijmegen Medical Centre, Department of Pediatric Physical Therapy, Nijmegen, The Netherlands. a.janssen@cukz.umcn.nl
Early Human Development
|August 1, 2009
Summary
A new prediction model accurately identifies preterm infants likely to have normal motor development at age 5. This approach can improve follow-up efficiency, reducing unnecessary assessments for many children.
Area of Science:
- Neonatal care
- Developmental pediatrics
- Motor development assessment
Background:
- Routine motor assessments at 5 years are often unnecessary for preterm infants, as ~60% show normal development.
- Inefficiency in current follow-up practices for preterm infant motor assessment.
Purpose of the Study:
- Develop a predictive model for 5-year motor performance in preterm infants.
- Achieve a sensitivity of at least 90% for accurate prediction.
- Enhance the efficiency of follow-up protocols for preterm infants.
Main Methods:
- Longitudinal study design including 371 preterm infants (gestational age ≤32 weeks), excluding those with severe disabilities.
- Used Movement Assessment Battery for Children (M-ABC) at 5 years as the dependent variable (delayed motor performance <15th percentile).
- Included 20 neonatal risk factors, maternal education, and Bayley Scales of Infant Development (2nd ed.) at 2.5 years as predictors.
Main Results:
- A predictive model developed using binary logistic regression achieved 94% sensitivity.
- Key predictors included: Motor Scale PDI <90, Behavior Rating Scale (BRS) motor quality <26th percentile, gestational age <30 weeks, male gender, and intra-ventricular hemorrhage.
- The model was validated on 345 infants.
Conclusions:
- The developed prediction model significantly enhances follow-up efficiency by 37%.
- Implementing the model would avoid assessments for 129 children while correctly identifying those needing intervention.
- This model offers a more targeted approach to motor assessment for preterm infants.
